Primary central nervous system lymphoma presenting with Parkinsonism as an initial manifestation: A case report and literature review

Okano,Rintaro; Suzuki,Kohei; Nakano,Yoshiteru; Yamamoto,Junkoh

doi:10.3892/mco.2021.2257

Primary central nervous system lymphoma presenting with Parkinsonism as an initial manifestation: A case report and literature review

Authors:
- Rintaro Okano
- Kohei Suzuki
- Yoshiteru Nakano
- Junkoh Yamamoto
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Affiliations: Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807‑8555, Japan
Published online on: March 12, 2021 https://doi.org/10.3892/mco.2021.2257
Article Number: 95

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Abstract

Primary central nervous system lymphoma (PCNSL) is a rare intracranial neoplasm in older adults. Tumor‑associated parkinsonism (TAP) in PCNSL is extremely rare, and its clinical features are unclear. The present report describes the case of a 75‑year‑old man who presented with parkinsonism due to multiple hyperintense lesions in the thalamus and periventricular white matter as visualized by magnetic resonance imaging (MRI). Due to the rapid progression of parkinsonism and lesion enlargement, the patient underwent stereotaxic biopsy. Subsequently, his condition was diagnosed as TAP in PCNSL at 2 months after onset. The patient completely recovered after treatment and experienced no recurrence of TAP for 8 months. Although it is difficult to distinguish TAP from vascular parkinsonism (VP) at initial consultation, the early diagnosis of PCNSL is important for improving prognosis. In the case of rapidly progressing parkinsonism, one should suspect the possibility of TAP associated with early‑stage PCNSL. Early treatment improves the chances of remission and decreases the possibility of recurrence.

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1	Schlegel U: Primary CNS lymphoma. Ther Adv Neurol Disord. 2:93–104. 2009.PubMed/NCBI View Article : Google Scholar
2	Villano JL, Koshy M, Shaikh H, Dolecek TA and McCarthy BJ: Age, gender, and racial differences in incidence and survival in primary CNS lymphoma. Br J Cancer. 105:1414–1418. 2011.PubMed/NCBI View Article : Google Scholar
3	Grommes C and DeAngelis LM: Primary CNS lymphoma. J Clin Oncol. 35:2410–2418. 2017.PubMed/NCBI View Article : Google Scholar
4	Lin CM and Hong K: Cerebral infratentorial large B-cell lymphoma presenting as Parkinsonism. Tohoku J Exp Med. 220:187–190. 2010.PubMed/NCBI View Article : Google Scholar
5	Nagarajan E, Yerram SY, Digala LP and Bollu PC: Primary central nervous system lymphoma presenting as parkinsonism with atypical MRI findings and elevated 14-3-3 protein. J Neurosci Rural Pract. 11:492–494. 2020.PubMed/NCBI View Article : Google Scholar
6	Pramstaller PP, Salerno A, Bhatia KP, Prugger M and Marsden CD: Primary central nervous system lymphoma presenting with a parkinsonian syndrome of pure akinesia. J Neurol. 246:934–938. 1999.PubMed/NCBI View Article : Google Scholar
7	Sánchez-Guerra M, Cerezal L, Leno C, Diez C, Figols J and Berciano J: Primary brain lymphoma presenting as Parkinson's disease. Neuroradiology. 43:36–40. 2001.PubMed/NCBI View Article : Google Scholar
8	Al-Janabi WSA, Zaman I and Memon AB: Secondary parkinsonism due to a large anterior cranial fossa meningioma. Eur J Case Rep Intern Med. 6(001055)2019.PubMed/NCBI View Article : Google Scholar
9	Connolly ID, Johnson E, Lummus S and Hayden Gephart M: Massive intradural chondroma masquerading as lower body parkinsonism. Cureus. 10(e2099)2018.PubMed/NCBI View Article : Google Scholar
10	Ertan S, Benbir G, Tanriverdi T, Alver I and Uzan M: Parkinsonism caused by cavernoma located in basal ganglion. Parkinsonism Relat Disord. 11:517–519. 2005.PubMed/NCBI View Article : Google Scholar
11	Margulies ME: Parkinsonism and brain tumor. J Nerv Ment Dis. 117:550–552. 1953.PubMed/NCBI
12	Sveinbjornsdottir S: The clinical symptoms of Parkinson's disease. J Neurochem. 139:318–324. 2016.PubMed/NCBI View Article : Google Scholar
13	Korczyn AD: Vascular parkinsonism-characteristics, pathogenesis and treatment. Nat Rev Neurol. 11:319–326. 2015.PubMed/NCBI View Article : Google Scholar
14	Linn J, Hoffmann LA, Danek A and Brückmann H: Differential diagnosis of bilateral thalamic lesions. Rofo. 179:234–245. 2007.PubMed/NCBI View Article : Google Scholar : (In German).
15	Renard D, Castelnovo G, Campello C, Bouly S, Le Floch A, Thouvenot E, Waconge A and Taieb G: Thalamic lesions: A radiological review. Behav Neurol. 2014(154631)2014.PubMed/NCBI View Article : Google Scholar
16	Haldorsen IS, Espeland A and Larsson EM: Central nervous system lymphoma: Characteristic findings on traditional and advanced imaging. AJNR Am J Neuroradiol. 32:984–992. 2011.PubMed/NCBI View Article : Google Scholar
17	Choi KH, Choi SM, Nam TS and Lee MC: Astrocytoma in the third ventricle and hypothalamus presenting with parkinsonism. J Korean Neurosurg Soc. 51:144–146. 2012.PubMed/NCBI View Article : Google Scholar
18	Duron E, Lazareth A, Gaubert JY, Raso C, Hanon O and Rigaud AS: Gliomatosis cerebri presenting as rapidly progressive dementia and parkinsonism in an elderly woman: A case report. J Med Case Rep. 2(53)2008.PubMed/NCBI View Article : Google Scholar
19	Yasuhara T, Agari T, Kambara H, Ichikawa T, Kurozumi K, Ono S, Miyoshi Y and Tokunaga K: Isao Date. Parkinsonism related to brain tumors: A case report and review of the literature. Open Neurosurgery J. 2:4–7. 2009.
20	Joutsa J, Horn A, Hsu J and Fox MD: Localizing parkinsonism based on focal brain lesions. Brain. 141:2445–2456. 2018.PubMed/NCBI View Article : Google Scholar
21	Kim JI, Choi JK, Lee JW and Hong JY: Intracranial meningioma-induced parkinsonism. J Lifestyle Med. 4:101–103. 2014.PubMed/NCBI View Article : Google Scholar
22	Merrill S, Mauler DJ, Richter KR, Raghunathan A, Leis JF and Mrugala MM: Parkinsonism as a late presentation of lymphomatosis cerebri following high-dose chemotherapy with autologous stem cell transplantation for primary central nervous system lymphoma. J Neurol. 267:2239–2244. 2020.PubMed/NCBI View Article : Google Scholar